Surgical Pathology Cancer Case Summary

LUNG:             Report

LUNG: Cytology/Biopsy

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

___ Cytology

___ Bronchial washings

___ FNA

___ Other (specify: _____________________)

___ Biopsy

___ Fiberoptic bronchoscopic

___ Transbronchial

___ Mediastinoscopic

TUMOR SITE

___ Right lung

___ Upper lobe

___ Middle lobe

___ Lower lobe

___ Left lung

___ Upper lobe

___ Lower lobe

___ Unknown

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Squamous cell carcinoma

___ Spindle cell (squamous) carcinoma

___ Small cell carcinoma

___ Oat cell carcinoma

___ Intermediate cell type carcinoma

___ Combined oat cell carcinoma

___ Adenocarcinoma

___ Acinar adenocarcinoma

___ Papillary adenocarcinoma

___ Bronchiolo-alveolar carcinoma

___ Solid carcinoma with mucus formation

___ Large-cell carcinoma

___ Giant cell carcinoma

___ Clear cell carcinoma

___ Adenosquamous carcinoma

___ Carcinoid tumor

___ Bronchial gland carcinoma

___ Adenoid cystic carcinoma

___ Mucoepidermoid carcinoma

___ Other(s) (specify:______________________)

___ Other (specify:____________________________)

HISTOLOGIC GRADE

___ GX: Cannot be assessed

___ G1: Well differentiated

___ G2: Moderately differentiated

___ G3: Poorly differentiated

___ G4: Undifferentiated

EXTENT OF INVASION (as appropriate)

___ Cannot be determined

___ Bronchus

___ In situ

___ Invasive

___ Pleura

___ Free of tumor

___ Involved by tumor

___ Blood/lymphatic vessels

___ Free of tumor

___ Involved by tumor

___ Mediastinal lymph node, extracapsular extension

___ Absent

___ Present

ADDITIONAL PATHOLOGIC FINDINGS*

___ None identified

___ Metaplasia (type: ____________________)

___ Dysplasia

___ Inflammation (type: __________________)

___ Other (specify: ______________________)

COMMENT

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